The American text-book of obstetrics for practitioners and students . nce of the uterine and pelvic axes. The obstruction to labordepends entirely upon the projection of the lumbar vertebrae. This projec-tion may be so slight as scarcely to influence the progress at all, or it may beso great as to make delivery by the natural channel quite impossible. There isnoticed in labor something; of the same mechanism that is seen in the flatpelvis for the purpose of overcoming the obstruction—namely, decreasedflexion, transverse position, and exaggerated lateral inclination of the account of th
The American text-book of obstetrics for practitioners and students . nce of the uterine and pelvic axes. The obstruction to labordepends entirely upon the projection of the lumbar vertebrae. This projec-tion may be so slight as scarcely to influence the progress at all, or it may beso great as to make delivery by the natural channel quite impossible. There isnoticed in labor something; of the same mechanism that is seen in the flatpelvis for the purpose of overcoming the obstruction—namely, decreasedflexion, transverse position, and exaggerated lateral inclination of the account of the forward dislocation of the external genitalia and of thepelvic floor, lacerations of the latter are the rule, and the tears are often com-plete into the rectum. This liability to injury is explained by the fact thatthe presenting part impinges directly upon the middle of the pelvic floor asit descends the birth-canal, instead of being directed forward to the vulvarorifice. Fistulae of the anterior vaginal wall are likewise common, from the DYSTOI I \. 31. 1. Contracted outlet of a kyphotic pelvis (Barbour). 2. Kyphotic pelvis from above (BarbourLumbosacral kyphosis (pelvis obteeta). 5. Asymmetrical contraction of the outlet from Types •>( Scoliotic rachitic pelves. DYSTOCIA. 61 localized pressure to which this region is subjected while the head is passingthe obstruction at the inlet. The presenting part is thrown forward by theprojecting vertebra?, and is received upon the prominent ridge f the pubicbone, greater in height and higher in situation than in the normal pelvis. Treatment of Labor Obstructed by Spondylolisthetic Pelvis.—The manage-ment of labor in these cases is governed by the same principles that obtain inthe management of labor in a flat pelvis. If the effectiveconjugate is over centimeters, the woman can be deliv-ered spontaneously, by forceps, or by version. With aneffective conjugate of between 7 and contimeters the
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Keywords: ., bookcentury1900, bookdecade1900, booksubjectobstetrics, bookyear1
